Customizable Letter

We have reviewed your Certification of Health Care Provider, dated [Enter Date] submitted in support of your request for leave under the Family and Medical Leave Act (FMLA). This letter is to inform you that your request for FMLA leave has been conditionally granted pending our receipt of a completed Certification executed by both you and the health care provider.

We are returning the Certification to you so that you can:

___ Sign the Certification

___ Have the Health Care Provider sign the Certification

___ Complete Section ___, Part ___, Question ___ of the Certification

Please complete and return the Certification within seven (7) calendar days. Failure to provide an executed and complete Certification may result in the delay or denial of your FMLA request and subject you to [Enter Employer's Name or the Company's] normal attendance policies.

If you have any questions, please do not hesitate to contact the undersigned.

Very truly yours,

_______________________________

[Enter Your Title]

Tips

An employer should receive a complete and clear certification form from all employees seeking FMLA leave. A health care provider's medical certification is an essential tool for employers when they receive a claim from an employee that their employer unlawfully denied their FMLA leave request and to combat fraud and abuse. Because of this, employers should remain diligent about authenticating, clarifying, validating and timely seeking all FMLA certifications.

An employee who is required to provide a certification in connection with a request for FMLA leave must provide the required certification within 15 calendar days after the employer's request, unless it is not practicable for the employee to do so despite the employee's diligent, good faith efforts or the employer provides a longer time for presentation of the certification.

Make sure the employee understands that any grant of FMLA leave is conditional upon receiving a fully completed medical certification form and that failure to return a complete form may subject the employee to discipline as set forth in the employer's attendance policy.

The DOL's Designation Notice form (Form WH-382) also includes a section that an employer can mark if additional information is needed to determine whether an FMLA request can be approved. The form specifically provides a category for certifications that are not complete and sufficient. In that category, the employer must provide the date by which the complete and sufficient certification must be delivered to the employer. The form also includes a space for the employer to detail the specific information that is needed to make a certification complete and sufficient.

Warnings

If an employer requires certification of the need for leave, it must include that requirement - and any consequences of a failure to provide certification - in both the employee eligibility and the employee rights and responsibilities notices. The first request for a certification must be in writing.

An employer operating in a state that has its own family and medical leave law should determine whether state or local laws limit the amount of medical information they can require in a certification to substantiate the need for leave (i.e., you do not want to say information is missing from the Certification form if the employee is not required to provide it).

If an employee does not return a complete certification within the seven day time period, an employer should be careful not to act hasty. Sometimes situations occur that make it impractical for an employee to respond within the seven day time period and the employer should first investigate.

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